Quantification of self-polishing in vivo from explanted metal-on-metal total hip replacements

One of the claimed advantages of metal-on-metal total hip replacements is that they ‘self-polish’ in the body, however this assertion has not been supported by quantitative data. Two pairs of components, each consisting of a femoral head and acetabular cup, were obtained at revision surgery. They were subject to topographical analysis using a non-contacting profilometer. In the ‘worn’ regions a reduction in surface roughness was seen alongside a change in skewness values from positive to negative, while elastohydrodynamic theory suggested an improvement towards mild mixed lubrication during gait. Therefore self-polishing of metal-on-metal total hip replacements can occur in vivo.